Title
Plasma concentration of C-reactive protein is increased in Type I diabetic patients without clinical macroangiopathy and correlates with markers of endothelial dysfunction: Evidence for chronic inflammation
Author
Schalkwijk, C.G.
Poland, D.C.W.
van Dijk, W.
Kok, A.
Emeis, J.J.
Dräger, A.M.
Doni, A.
van Hinsbergh, V.W.M.
Stehouwer, C.D.A.
Gaubius instituut TNO
Publication year
1999
Abstract
Moderately increased plasma concentrations of C-reactive protein are associated with an increased risk of cardiovascular disease, C-reactive protein, its relation to a low degree of inflammatory activation and its association with activation of the endothelium have not been systematically investigated in Type I (insulin-dependent) diabetes mellitus. C-reactive protein concentrations were measured in 40 non-smoking patients with Type I diabetes without symptoms of macrovascular disease and in healthy control subjects, and in a second group of Type I diabetic patients (n = 60) with normo- (n = 20), micro- (n = 20) or macroalbuminuria (n = 20). Differences in glycosylation of α1-acid glycoprotein were assayed by crossed affinity immunoelectrophoresis. Activation of the endothelium was measured with plasma concentrations of endothelial cell markers. The median plasma concentration of C-reactive protein was higher in Type I diabetic patients compared with healthy control subjects [1.20 (0.06-21.64) vs 0.51 (0.04-9.44) mg/l; p < 0.02]. The Type I diabetic subjects had a significantly increased relative amount of fucosylated α1-acid glycoprotein (79 ± 12% vs 69 ± 14% in the healthy control subjects; p < 0.005), indicating a chronic hepatic inflammatory response. In the Type I diabetic group, log(C-reactive protein) correlated significantly with von Willebrand factor (r = 0.439, p < 0.005) and vascular cell adhesion molecule-1 (r = 0.384, p < 0.02), but not with sE- selectin (r = 0.008, p = 0.96). In the second group of Type I diabetic patients, increased urinary albumin excretion was associated with a significant increase of von Willebrand factor (p < 0.0005) and C-reactive protein (p = 0.003), which were strongly correlated (r = 0.53, p < 0.0005). Plasma concentrations of C-reactive protein were higher in Type I diabetic patients without (clinical) macroangiopathy than in control subjects, probably due to a chronic hepatic inflammatory response. The correlation of C-reactive protein with markers of endothelial dysfunction suggests a relation between activation of the endothelium and chronic inflammation.
Subject
Biology
α1-Acid glycoprotein
Acute-phase response
Atherosclerosis
C- reactive protein
Fucosylation
Type I (insulin-dependent) diabetes mellitus
Vascular disease
Adult
Albuminuria
Biological Markers
Body Mass Index
C-Reactive Protein
Diabetes Mellitus, Type 1
Diabetic Angiopathies
E-Selectin
Endothelium, Vascular
Female
Fibrinogen
Hemoglobin A, Glycosylated
Humans
Inflammation
Male
Orosomucoid
Phospholipases A
Reference Values
Regression Analysis
Vascular Cell Adhesion Molecule-1
von Willebrand Factor
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http://resolver.tudelft.nl/uuid:62891076-c0c9-4de5-8fe6-2b60cb22944d
DOI
https://doi.org/10.1007/s001250051162
TNO identifier
234978
ISSN
0012-186X
Source
Diabetologia, 42 (3), 351-357
Document type
article